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Physicians have enough to consider as it is, as it is difficult enough determining which treatments and options will best benefit each patient's values and interests. Hardwig had the moral reasons for presumption of equality, but no solid explanations as to how the principle could be implemented. Patient autonomy would have to be sacrificed in order for the idea of presumption of equality to be honored.
I think that the interests of family members and those close to an individual should always be taken into consideration, but not necessarily given equal importance. Naturally family members can persuade, support, and participate in discussion and the joint decision making process, but when there is a conflict between autonomy and respect for the interests of family members, autonomy wins out...
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